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The Blog of Dr. Ann Conn


New Study Strengthens Case for Injections in Chronic Low Back Pain

8/20/2014 9:19 am
Posted by Dr. Ann Conn

A new study in Pain Physician (2014;17:E489-E501) suggests that transforaminal epidural injections are an effective way to manage chronic low back pain especially for disk herniation and spinal nerve irritation. In patients with pain for greater than 6 months, researchers found …


Lumbar Disc Degeneration Associated with Genetic Mutation

1/8/2014 12:22 pm
Posted by Dr. Ann Conn

A large genetic study in families with early onset of lumbar disc disease revealed a gene mutation linked to the enzymes that form the ‘jelly’ within lumbar discs.  This mutation impaired the key enzyme that provides hydration of the center …


Brain Changes Predict Development of Chronic Pain

10/21/2013 11:41 am
Posted by Dr. Ann Conn

Changes in brain circuits are associated with the conversion of acute pain to chronic pain.   Corticostriatal functional connectivity predicts transition to chronic back pain Marwan N. Baliki; Bogdan Petre; Souraya Torbey; Kristina M. Herrmann; Lejian Huang; Thomas J. Schnitzer; …


Transcranial Direct Current Stimulation for Chronic Pain Treatment

10/17/2013 1:10 pm
Posted by Dr. Ann Conn

Transcranial Direct Current Stimulation (tDCS) is low current brain stimulation.  Many applications are currently under investigation, including treatment of chronic pain.  Zachary Leuschner MD of Albert Einstein College of Medicine, presented information at the 2013 meeting of the American Pain …


Only 416 Board Certified Headache Specialist in US

7/11/2013 9:58 am
Posted by Dr. Ann Conn

At the International Headache Congress in Boston last month, Noah Rosen MD presented a study regarding access to Headache Specialist.  The United Council for Neurologic Subspecialties lists 416 Board Certified Physicians.  This represents a significant shortage.  Our neighbor Mississippi has …


Portable Vagus Nerve Stimulator for Migraine

6/11/2013 1:45 pm
Posted by Dr. Ann Conn

Portable Vagus Nerve Stimulation (VNS) may be helpful to stop migraine.  A small study of 30 patients was presented at the American Academy of Neurology Annual Meeting 2013 in San Diego that revealed noninvasive VNS can be effective for rescue …


Probiotics Affect Brain Activity

6/5/2013 12:42 pm
Posted by Dr. Ann Conn

A new study revealed that women who frequently consumed probiotic yogurt had changes in the brain regions that are associated with emotional processing seen by functional MRI.  Lead investigator, Kirsten Tillisch, MD of  UCLA’s Geffen School of Medicine, observed the …


Low Back Pain Linked to Bacterial Infection

6/3/2013 12:54 pm
Posted by Dr. Ann Conn

It is possible that 40% of chronic low back pain is related to bacterial infection.  A study published in European Spine Journal revealed that a group of patients with both disc herniation and Modic type 1 changes demonstrated by MRI could be helped …


Migraine, Depression & Brain Size

5/29/2013 11:54 am
Posted by Dr. Ann Conn

Patients that suffer with both depression and migraine may have smaller brains.  It has been shown that patients with migraine have an increase incidence of depression.  A new study published by Larus S. Gudmundsson, PhD, revealed that patients with both depression …


Trigeminal & Occipital Stimulation for Migraine

5/13/2013 9:19 am
Posted by Dr. Ann Conn

At out Northshore clinic, we have been treatment an increasing number of patients with trigeminal and occipital neurostimulation.  We have seen significant success with these procedures.  Below in a seminal article on Neurostimulation for migraine.  I fully evaluate, diagnose and …


Portable TMS for Migraine Treatment

5/2/2013 8:08 am
Posted by Dr. Ann Conn

Transcranial Magnetic Stimulation (TMS) is a potential new treatment for migraine.  TMS is approved and a portable device is available in Europe.  This therapy is to stop a migraine in patients that have migraine with visual changes or aura.  The …


Causes of Low Back Pain

4/24/2013 12:17 pm
Posted by Dr. Ann Conn

The April 24, 2013 issue of the Journal of the American Medical Association contains an excellent patient education page regarding low back pain.  The link is below.  We are continuously evaluating new way of approaching and treating patients at our northshore …


Yoga May Help Boost Mental Health

4/16/2013 12:27 pm
Posted by Dr. Ann Conn

The review of over 100 studied by Dr. Murali Doraiswamy of Duke University revealed that yoga is effective in coping with anxiety, depression and stress.  Of the studies reviewed for his article in, Frontiers in Affective Disorders and Psychosomatic Research, 16 …


Fibromyalgia Associated with Abnormal Brain Receptor Function

4/1/2013 12:00 pm
Posted by Dr. Ann Conn

A presentation at the 2012 American College of Rheumatology Meeting examined abnormal pain processing in the brain of patients with fibromyalgia.  The brain’s normal pain inhibiting processes malfunction in these patients.  The study revealed a connection between u-opioid receptor function and …


Exercise & Counseling Reduced Days Off With Back Pain in Recruits

3/28/2013 9:59 am
Posted by Dr. Ann Conn

A study published March 2013 in Spine revealed fewer lost work days due to low back pain in military recruits in Finland when treated with exercise and counseling.  791 recruits were followed for six months.  They were instructed to avoid full …


Pain in Lumbar Spinal Stenosis Worsened with Vitamin D Deficiency

3/20/2013 9:33 am
Posted by Dr. Ann Conn

A study published in the March issue of Pain Physician Journal examined the relationship between pain in lumber stenosis and Vitamin D Deficiency.   The patients were evaluated bases on location and severity of pain.  The groups for analysis were …


MRI for Assessment of Sciatica

3/14/2013 10:40 am
Posted by Dr. Ann Conn

In the March 14, 2013 issue the  New England Journal of Medicine published an article on the use of MRI to evaluate persistent sciatica in cases of known lumbar disc herniation.  The study found that 1 year after treatment, MRI imaging did …


Our Personal Experience with Cefaly

3/12/2013 1:20 pm
Posted by Dr. Ann Conn

We are excited to have a new migraine prevention treatment to offer.  Several of our patients have been using Cefaly for external trigeminal nerve stimulation.  The initial reaction from patients has been positive.  The stimulation is not experienced as painful. …


Cervicogenic Headache (Neck Problems Causing Headache)

3/6/2013 2:04 pm
Posted by Dr. Ann Conn

With Cervicogenic Headache,  head and neck movement increase headache.  Problems with the facet joints of the upper neck are often associated with this type of pain.  These facet joints commonly develop arthritis.  The upper three joints are associated with the …


Nerve Stimulation of Face & Migraine Prevention

2/26/2013 2:12 pm
Posted by Dr. Ann Conn

  This device, applied to the forehead for 20 min per day for 3 months, reduced headache by 50%!!!  An article published in the February 19,2013 issue of  Neurology presents the study.  The device, named Cefaly, is currently available through several …


Migraines, Opioids & Butalbital

2/25/2013 12:00 pm
Posted by Dr. Ann Conn

A recent article in Neurology Today discussed treatment and tests that are over utilized and minimally effective.  The US is the only country in which butalbital is approved for headache treatment.  The medication is minimally helpful and can worsen headache.  Bultalbital slows thinking and …


MRI & Low Back Pain

2/22/2013 2:30 pm
Posted by Dr. Ann Conn

As we try to utilize medical dollars more efficiently, medical societies will providing more opinions and guidelines regarding diagnosis and treatment of illness.  Recently, both the American Academy of Family Physicians and American College of Physicians published recommendations regarding imaging and low back …


European Union Approves Neurostimulation for Chronic Migraine

2/14/2013 11:37 am
Posted by Dr. Ann Conn

Just yesterday I implanted a trigeminal nerve stimulator in a patient for chronic migraine.  At our Northshore Clinic, we have been fortunate to participate in the care of multiple longterm chronic migraine patients whose lives have been drastically improved with …


Does Exercise Protect the Brain?

2/13/2013 2:26 pm
Posted by Dr. Ann Conn

A recent study published in The Annals of Internal Medicine, revealed on associations between physical fitness and decrease risk for dementia.  Dr. Laura F. DeFina, the lead author, stated that middle age patients in the 20% highest level of fitness, have 36% …


Leg Pain Associated with Low Back Problems

2/7/2013 12:00 pm
Posted by Dr. Ann Conn

Leg pain is commonly associated with back trouble.  The leg pain is often caused by a disc bulge or bone spurs.  At our Northshore Clinic in Mandeville, MRI and Xray of the Lumbar Spine are evaluated to determine the cause …


Silver Linings Playbook & Mental Health

2/6/2013 12:31 pm
Posted by Dr. Ann Conn

David O. Russell, the director of Silver Linings Playbook, was recently interviewed on the Today Show.  He discussed his son Matthew’s struggle with a mood disorder and how it informed his choices making this movie.  Mr. Russell described a healing  understanding with …


FDA Panel Recommends Increased Restrictions on Hydrocodone

1/28/2013 3:20 pm
Posted by Dr. Ann Conn

  On Friday January 25,2012, an FDA advisory panel recommended increased restrictions on hydrocodone.  These recommendations were widely reported by CBS Evening News, ABC World News, CNN, The New York Times and Los Angeles Times among others.  If approved, hydrocodone …


Lumbar Extensor Exercises Improve Chronic Back Pain

1/24/2013 11:57 am
Posted by Dr. Ann Conn

A recent study showed that lumbar exercises improved function in a group of men when done once a week for ten weeks.  The benefits lasted at least 6 months.  The patients has chronic nonspecific low back pain and had MRI’s …


Privacy Concerns with Genetic Databases

1/23/2013 12:00 pm
Posted by Dr. Ann Conn

Anonymous donors for the 100 Genome Project were identified by public genealogy records and gene sequencing tools.  This is a window into the privacy risks of sharing genetic data.  12% of the anonymous donors were identified said Yaniv Erlich, a …


Unlicensed Stem Cell Therapies Ruled Subject to FDA Regulation

1/22/2013 1:51 pm
Posted by Dr. Ann Conn

A recent ruling in US District Court in US vs Regenerative Sciences declared that stem cell therapies are “drugs” and “biologics” and subject to regulation by the FDA.  This ruling will help reign in the ‘wild west’ atmosphere of stem …


Acupuncture for Chronic Pain

1/15/2013 12:19 pm
Posted by Dr. Ann Conn

As treatment options for chronic pain evolve, scientific analysis of alternative and complementary techniques will inform our selection of these modalities.  A recent article in Archives of Internal Medicine reviewed Acupuncture for Chronic Pain.  Studies that evaluated acupuncture for treating …


Causes of Low Back Pain

1/14/2013 11:23 am
Posted by Dr. Ann Conn

Low back pain is a common problem with 80% of adults in the United States suffering at some point in their lives.   Complaints of low back pain are the fifth most common reason for physician visits in adults.  There …


Brain Trauma & Suicide in Junior Seau

1/11/2013 12:19 pm
Posted by Dr. Ann Conn

Multiple news sources this week reported on the autopsy of Junior Seau, the football player who died of suicide last year.  The Seau’s family donate his brain to the National Institute of Health for study of traumatic brain injury.  They …


Mindfulness Mediation

1/8/2013 12:00 pm
Posted by Dr. Ann Conn

Mindfulness mediation is a potentially rich area for pain treatment.  During the last several years, scientific study of meditation has advanced.  Dr. Richard Davidson at University of Wisconsin Madison is a leader in the field.  I’m looking forward to his …


Migraine & Changes in Brain MRI

1/7/2013 12:00 pm
Posted by Dr. Ann Conn

Migraine can be associated with changes in MRI of the brain.  These brain changes are called deep white matter hyperintensities (DWMH).  Research published in the November 14 Jama followed a group of women with migraine.  The MRI changes were not …


Depression & Changes in Migraine Headaches

1/4/2013 12:00 pm
Posted by Dr. Ann Conn

Migraine headaches can change from occasional attacks to chronic migraine.  This change (transformation) in migraine pattern can be associated with depression.  Research published in Journal of Headache Pain revealed that increased severity of depression increases risk of headache transformation.  And, …


Regenerative Medicine

12/28/2012 4:01 pm
Posted by Dr. Ann Conn

An impending paradigm shift in Interventional Pain Medicine is the promotion of regeneration of worn-out tissue.  Along with injections, joint replacement, medical management, and other established comprehensive care, the field of Regenerative Medicine is evolving to take its place in pain management.  …


Anti-inflammatory Diet & Pain

12/19/2012 12:00 pm
Posted by Dr. Ann Conn

Many pain conditions are associated with chronic low-grade inflammation.  Some studies support adherence to an anti-inflammatory diet as part of a comprehensive pain management program.  This type of diet may decrease inflammatory mediators or factors that contribute to increased inflammation in …


Medical Virtual Reality Treatment

12/18/2012 12:00 pm
Posted by goodwork

Mental preparation for entering a stressful environment is undergoing a revolution.  One of the leaders of this revolution is Dr. Albert Rizzo a psychologist at USC Keck School of Medicine.  The collaboration between the military, Hollywood and USC’s Institute for …


Postconcussion Syndrome Persist for Years after TBI

12/17/2012 12:00 pm
Posted by goodwork

TBI during deployment can have long -term consequences for soldiers and continue to affect daily life and require many years of treatment.  The major symptoms of Postconcussion Syndrome studied included headache, dizziness, balance difficulty, poor coordination, difficulty with decisions, and …


Traumatic Brain Injury & Migraine in Solders

12/14/2012 12:00 pm
Posted by goodwork

Soldiers returning home from combat with mild traumatic brain injury (TBI) have migraine in 29% compared to soldiers without TBI at 12%.  The alarming statistic from the study conducted by Ann I. Scher, PhD at Uniformed Services University is that …


New Class of Medications for Insomnia

12/13/2012 7:31 pm
Posted by goodwork

The new drug, suvorexant, acts on orexins in the brain to improve sleep.  This is the first medication to block orexin, a neurotransmitter deep within the brain.  It allowed patients stayed asleep longer with decreased awakenings during the night.  Suvorexant …


Stress Management Using Virtual Environments

12/4/2012 2:53 am
Posted by

Mental preparation for entering a stressful environment is undergoing a revolution. One of the leaders of this revolution is Dr. Albert Rizzo a psychologist at USC Keck School of Medicine. The collaboration between the military, Hollywood and USC’s Institute for Creative Technologies, has yielded a new category of medical virtual reality.


Brainstorm – SNOOP

12/3/2012 10:14 pm
Posted by goodwork

How Your Brain Can Control Pain

12/3/2012 10:13 pm
Posted by goodwork

Yoga For Headaches

12/3/2012 3:12 pm
Posted by goodwork

Migraines and Anti-inflammatories

12/1/2012 8:57 pm
Posted by

Anti-inflammatories are mainline migraine therapy.  This class of medication can both stop a headache and, prevent some migraine patients from developing more frequent headaches.  An appropriate dose of anti-inflammatory is usually twice a week.  If migraines are not controlled on …


Journal Article by Dr Conn in Pain Physician

11/27/2012 8:15 pm
Posted by

Systematic Review of Caudal Epidural Injections in the Management of Chronic Low Back Pain


Journal Article by Dr Conn in Pain Physician

11/27/2012 8:15 pm
Posted by

Systematic Review of the Effectiveness of Cervical Epidurals in the Management of Chronic Neck Pain


Journal Article by Dr Conn in Pain Physician

11/27/2012 8:14 pm
Posted by

Comprehensive Evidence-Based Guidelines for Interventional Techniques in the Management of Chronic Spinal Pain


Journal Article by Dr Conn in Pain Physician

11/20/2012 4:42 pm
Posted by

Caudal Epidural Injections in the Management of Chronic Low Back Pain: A Systematic Appraisal of the Literature


Desk Jobs Take a Toll on Your Body

11/16/2012 3:40 pm
Posted by

Dr. Conn was quoted in the most recent article of North Shore Life. Read the full article below.


Fibromyalgia Symptoms Public Service Announcement

11/9/2012 8:13 pm
Posted by

Tai Chi and Chronic Pain

11/8/2012 7:50 pm
Posted by

Complementary and Alternative Medicine are now being invested from a scientific viewpoint.  Hopefully, this analysis will expand and enrich treatment possibilities. Tai Chi is a potential treatment option for chronic pain. Tai Chi can be valuable in chronic pain management …


Lumbar Disc Sealant

11/7/2012 5:58 pm
Posted by

Pain from disc problems in the lower back can be challenging to treat.  A promising new therapy for disc pain is Lumbar Disc Sealant.  The procedure treats chronic low back pain from disc problems.  This treatment is currently in trials …


Caffeine and Fibromyalgia Pain

10/21/2012 1:09 pm
Posted by

A new study reveals a link between high levels of caffeine consumption and increased fibromyalgia pain. Lead investigator, Steven E. Harte PhD of University of Michigan, studied 252 patients with fibromyalgia.  Those consuming 4 cups of coffee or greater per …


Fish Oil for mood issues and pain

10/21/2012 1:06 pm
Posted by

Fish Oil may provided the building blocks to help heal damaged cells in the nervous system and prevent cell death.  There is evidence that Fish Oil helps treat mild to moderate depression, ADHD, bipolar disorder and other mood issues.  Fish …


RFA and whiplash

10/21/2012 1:05 pm
Posted by

Radiofrequency Ablation (RFA) of the cervical spine appears helpful for chronic whiplash pain of the neck.  RFA is a procedure that uses radiofrequency energy to stun the small branch nerves to the joints in the neck.   Researchers in Canada and …


Osteoarthritis and Genetics

10/21/2012 1:01 pm
Posted by

Osteoarthritis is a common pain source.  Almost everyone has symptoms by the age to 70.  This problem is mainly due to joints wearing, trauma and aging.  Although, physician have observed that some families seem to develop osteoarthritis (OA) early and …


Transcranial Magnetic Stimulation

10/21/2012 12:57 pm
Posted by

Thankfully, most painful conditions respond to standard treatments. Unfortunately, some pain syndromes are difficult to manage and do not response well to our currently available therapies.  A recent article in PainMedicineNews.com discussed repetitive Transcranial Magnetic Stimulation (rTMS) for nerve pain …


Chronic Migraine

10/21/2012 12:54 pm
Posted by

Chronic Migraine is a difficult problem.  This is a headache condition that occurs 15 days per month and lasts 4 hours with at least half of the headaches being migraines.  Chronic Migraine effects 4% to 5% of the population.   A …